Steven Fletcher's line in the sand (with video)

Winnipeg MP Steven Fletcher's campaign to legalize physician-assisted death is part of an intensely personal quest rooted in the searing memory of the pain he suffered after a near-fatal car accident. He doesn't want to experience anything like it again — and he wants the law changed to ensure it.

On the first Friday in January 2012, then federal cabinet minister Steven Fletcher listened with gathering alarm to his Winnipeg surgeon.

The doctor had summoned him to an urgent meeting to discuss the results of a recent MRI, which Fletcher had undergone after falling from his wheelchair in the shower. A quadriplegic — the first ever to join cabinet — Fletcher had also been suffering from a persistent sore throat. He was treating it with cough drops.

Fletcher’s doctor told him he needed surgery: The titanium rod implanted in 1996 to support the shattered bones in his neck had become dislodged.

Two screws that attached the bottom of the rod to the front of his cervical vertebrae had failed. It meant, the surgeon told Fletcher, that the rod could soon penetrate his throat.

The Conservative MP for Charleswood-St. James-Assiniboia-Headingley had some questions. Could the surgery be delayed until the House of Commons took its summer break? No. Then what would happen, Fletcher asked, if they didn’t operate at all?

“He knew what I was saying,” Fletcher, 42, remembers now. “And he said, ‘What will happen is that the rod will go into your throat, into your esophagus, and you will die a miserable death.’”

MP Steven Fletcher, who lives in a wheelchair after a car accident left him a quadriplegic, is leading the charge for assisted dying legislation.Ottawa Citizen

Fletcher is determined to avoid such an end. So after meeting with his surgeon, he went directly to the office of his lawyer, Winnipeg’s John Restall, to update his living will.

Fletcher set out in unsparing terms the conditions under which he wanted to die if the operation went badly.

Despite being a cabinet minister, a man at the apex of his political career, Fletcher said he didn’t want to continue living if he lost the ability to see, speak, or hear, or if he suffered serious brain damage.

Today, more than two years after that meeting, Fletcher’s direction to his substitute decision-makers remains unchanged. He wants medical services withdrawn, and if necessary, an assisted death.

“This is as much disability as I can handle,” explains the politician who has become a leading voice in Canada’s right-to-die debate.

Steven Fletcher signs his name after being sworn into cabinet as Minister of State (Transport) in May 2011. When he was shuffled out two years later, it meant he could pursue his own political agenda free of the straitjacket of cabinet solidarity for the first time in five years.David Kawai /
Ottawa Citizen

He has assumed that role by introducing two bills into Parliament to legalize and monitor physician-assisted death. For Fletcher, the issue is neither theoretical nor abstract: His campaign is part of an intensely personal quest rooted in the searing memory of the pain he suffered after a near-fatal car accident.

His first months in hospital, Fletcher says, were nothing less than “well-intentioned torture.” He’s determined never to suffer like that again and he wants federal law remade to ensure it.

“Under no circumstances do I ever want to repeat what I had to go through. Under no circumstances,” he said during recent interviews in his Centre Block office.

“I’ve gone through that once. And if I had known ahead of time what was going to be in front of me for the next half a dozen years, I would have said, ‘Just no thank you. It’s just not worth it…’

“Even from where I sit today. That’s how bad it was.”

Steven Fletcher, in 1989, on a canoe trip to Manitoba’s Snowshoe Lake. Fletcher, an avid outdoorsman, loved nothing more than taking to the water in a canoe or kayak. He had a summer job leading canoe trips and was an expert paddler: he taught camp counsellors how to instruct young people in the art of handling a canoe.Courtesy Steven Fletcher /
Ottawa Citizen

The accident

As he drove north on Manitoba’s Highway 304, in the dark of a winter’s morning, Steven Fletcher’s mind was full of the future.

It was Jan. 11, 1996. Days earlier, the 23-year-old geological engineer had completed a successful job interview with Kinross Gold in Kirkland Lake. He would have to give notice to his current employer, the Rea Gold Corporation, where he was an engineer-in-training, and prepare for his move to Northern Ontario.

He also had to deliver a speech to the Manitoba Recreational Canoe Association and find more time for his increasingly serious girlfriend.

Life was charging ahead according to plan. He wanted to return to school to obtain his MBA then spend his career in mining or maybe Alberta’s booming oilsands. He’d get married, have lots of kids, and introduce them to the boundless joy of exploring the Canadian wilderness in a canoe.

Steven Fletcher with his parents, David and Joanne, on the occasion of his graduation from the University of Manitoba with a degree in geological engineering in June 1995. Fletcher wanted a career in mining or the oil sands.Courtesy Steven Fletcher /
Ottawa Citizen

A moose changed everything in an instant.

Fletcher doesn’t remember the moment of impact. The police report says the moose crashed through Fletcher’s roof and windshield — he was wearing a seatbelt — sending his car into the opposite ditch. The car slammed to a stop and the moose pitched forward from the backseat, battering Fletcher for a second time as it catapulted into the ditch.

Fletcher was still about half an hour from his intended destination: the small town of Bissett and its gold mine.

“I remember being in the ditch, unable to move, conscious.”

He was found in that desperate state half an hour later by two Manitoba Telephone Service workers who stopped to investigate what appeared to be a headlight shining up out of the ditch.

Fletcher was pried from the vehicle and driven by ambulance to Winnipeg since doctors in the nearby town of Pine Falls were not equipped to deal with his profound spinal cord injury. Two vertebrae in his neck had been crushed.

Fletcher was in electrifying pain and had to fight for each breath. His parents, David and Joanne, were told he might not survive.

“The pain was so intense that you just think you’re going to explode,” he remembers. “You’d wish anything, anything to stop it.”

For two days after the accident — before his lung collapsed and he was placed on a mechanical ventilator — Fletcher could still talk. Somehow, his sense of humour remained intact. When an uncle, John Hobbs, came to see him in intensive care, he struggled to find the right words. Fletcher broke the silence.

“Uncle John,” he croaked, “you should see the moose.”

Steven Fletcher with his father, David, in hospital in early 1996 after the car accident that left him a quadriplegic.Photo courtesy of Fletcher family /
The Ottawa Citizen

The aftermath

Each successive day in hospital expanded the dimensions of Fletcher’s pain, trauma and grief.

As a “C4” quadriplegic — the higher the break on the spinal column, the more profound the paralysis — Fletcher could move only his neck and face muscles. He needed assistance to bathe, roll over in bed, brush his teeth, empty his bowels. Intubated, he relied on nurses to suction phlegm from his breathing tube.

Often, he felt like he was drowning but he had no way to communicate his mortal distress: He was unable to talk with a tube in his throat. Nursing help was difficult to summon during the night. Fletcher could only click his tongue during moments of panic.

“You can’t sleep when you can’t breathe: It was total exhaustion,” he remembers.

“I was terrified. I can’t talk. I can’t write anything down. I have no real means of communicating. I’m fully conscious and I’m in enormous pain.”

Other features of his new reality sank in with aching finality. He came to understand that he would never climb into another canoe, walk into another gold mine, or father his first child. The life plan he had built for himself was in ruins.

Four months after his accident, Fletcher had his breathing tube removed, restoring his ability to speak.

“The first thing I did,” he remembers, “I told my mom and dad, my brother and sister how much I loved them. Then I asked for a lawyer.”

Fletcher had his lawyer draft a living will that instructed doctors not to revive him should he suffer a stroke or any relapse that would further incapacitate him. He did not want to endure a similar nightmare.

Fletcher didn’t know it, but he had already arrived upon the issue that would become the defining fight of his political career: the right to die with dignity.

He spent almost a full year in hospital after the accident. Fletcher tunnelled into depression when his girlfriend left for Toronto, but found the strength to climb back out again. In time, he turned his mind to engineering a new future for himself.

His first job was to convince health officials that he could live on his own rather than in a nursing home. No one with Fletcher’s level of disability had ever attempted such a thing in Manitoba.

Overcoming one barrier after another, Fletcher put together a team of personal care workers and physiotherapists to meet his around-the-clock needs. He moved into an accessible apartment, passed the admissions test for business school — he hired a scribe to help him write the test — and was accepted into the University of Manitoba’s MBA program in May 1997.

Fletcher had to fight with the province’s public auto insurance agency to win funding for the supports he needed to live what he considered a meaningful life. The process introduced him to the art and power of public advocacy.

Each victory and each new measure of independence fed his confidence. Within two years, he was president of the university’s students’ union. Re-elected in 2000 on a platform that stressed fiscal responsibility, he balanced the student group’s books for the first time in decades.

Steven Fletcher is congratulated by supporters as he arrives at his campaign office after upsetting star Liberal candidate Glen Murray in Charleswood-St. James in the 2004 general election. Since then, Fletcher has won the riding another three times, earning more votes in each successive campaign.Mike Aporius /
Winnipeg Free Press

Politics was a field where ideas mattered more than motor skills, and Fletcher saw in it a place for himself. His ambitions mounted. While still student president, he challenged for a provincial Tory nomination, and although he lost, Fletcher established himself as a dynamic young star.

So much so that he was elected president of the Progressive Conservative Party of Manitoba in November 2001; he was just 29, the youngest person ever to hold the office. Fletcher went from success to success. Re-elected party president, he later won the federal nomination in Charleswood-St. James, and upset star Liberal candidate Glen Murray, the former mayor of Winnipeg, in the 2004 general election.

Since then, Fletcher has won the riding another three times, earning more votes in each successive campaign.

The surgery

The medical news kept getting worse.

Back in Ottawa, two days after being told the titanium rod in his neck needed urgent repair, Fletcher sought another medical opinion. The second doctor concluded the problem was “even more progressive” and potentially dangerous than first described.

Fletcher phoned Toronto Western Hospital’s Dr. Michael Fehlings, one of the country’s top spinal neurosurgeons, who agreed to see him the next day given the extraordinary nature of the case.

After a battery of tests, Dr. Fehlings offered a still more dire assessment: There was no structural scaffold left to hold up Fletcher’s head; only the muscles and ligaments in his neck were keeping it in place. What’s more, the two vertebrae in his neck had fractured again.

Emergency surgery was scheduled.

Stephen Harper, shown at a stop in Steven Fletcher’s campaign office in 2005, ‘could not have been more humane, empathetic and thoughtful,’ when Fletcher offered to step down from cabinet in 2012 because he needed to undergo emergency surgery. Fletcher says he was told to just worry about getting better.Ken Gigliotti /
Winnipeg Free Press

Fletcher attended a Treasury Board meeting then sought an audience with Prime Minister Stephen Harper and his chief of staff, Nigel Wright. Fletcher informed them of his pending surgery, and offered to step down from cabinet given that doctors thought his recovery could take up to a year.

“Just worry about getting better,” Wright told him.

Fletcher chokes on emotion in recalling the moment. Having his health and career threatened at a time when he had overcome so much to reach cabinet seemed a particularly cruel turn of fate. He was grateful for the chance to continue.

“The prime minister and Nigel Wright could not have been more humane, empathetic and thoughtful,” Fletcher says.

In Toronto, he met with his surgeons to ensure that his living will would be respected in case something went seriously wrong during the operation.

“I told my doctors if anything goes wrong, if my cognitive ability is reduced in any way or my ability to speak or hear or whatever, please walk away from the table. I said that again with my parents and siblings in the room so there was no question about it.”

Patients must consent to treatment, and all Canadians have the right to ask that medical services be withdrawn.

But Fletcher also discussed with his family the circumstances under which he wanted an assisted death. His parents and sister argued with him to no avail.

“With a C4 quadriplegic, there’s not a lot left that can go wrong. But whatever is left, I need it all. And if I can’t have all of what is left, then I want the option to end my life…

“If I’m incapacitated, the direction is to actively end my life, not passively. I’m not interested in starving to death, or being de-liquefied, or whatever.”

In his personal health care directive, Fletcher does not set out a preferred mechanism for an assisted death which, in any event, remains prohibited by federal law. “I have not asked my family to do anything illegal,” he says, “but I am trying to change the law.”

Fletcher’s operation lasted 12 hours. During the surgery, Dr. Fehlings discovered that the displaced titanium rod in Fletcher’s neck had penetrated his throat, creating a dangerous pathway for infection. Bacteria had already colonized Fletcher’s spinal column. One of the structure’s anchoring screws could not be found at all.

The wound was cleaned, the failed support was removed, and a new, much larger rod was implanted that travelled from Fletcher’s head to the middle of his spine.

Fletcher was back at work on Parliament Hill within two months. And this time, he told colleagues, his head was screwed on right.

The cause

During his difficult journey as a quadriplegic, Steven Fletcher has maintained a dark and abiding sense of humour — something he drew upon after getting dumped from cabinet in July 2013.

“I am a Conservative. I am a traditionalist,” he tweeted. “I wish I left cabinet in the traditional way — with a sex scandal.”

Steven Fletcher speaks with the media in March, the month he introduced two bills to the House of Commons: One establishes the conditions under which physician-assisted death can take place; the other creates a commission to monitor implementation of the law.Adrian Wyld /
The Canadian Press

Fletcher was instead the victim of a numbers game. Harper wanted more women in cabinet and, with Manitoba MPs Shelly Glover and Candace Bergen joining the ranks, he couldn’t justify a third minister from the province.

The unexpected setback had one silver lining: It meant Fletcher could pursue his own political agenda free of the straitjacket of cabinet solidarity for the first time in five years.

It didn’t take him long to settle on his top priority: a bill to legalize physician-assisted death.

He conducted six months of research, told his family about his plans, and introduced two bills to the House of Commons in March: One establishes the conditions under which physician-assisted death can take place; the other creates a commission to monitor implementation of the law.

The bills were introduced as the issue percolated across the country.

In June, Quebec became the first province to pass right-to-die legislation. In August, the Canadian Medical Association voted overwhelmingly in favour of allowing doctors to follow their consciences in caring for dying patients. Then last month, the Supreme Court of Canada heard arguments about whether the federal prohibition on assisted dying should be lifted for the terminally ill. A series of public opinion polls revealed broad support for the idea.

The Conservative government, however, has shown little interest in Fletcher’s proposed legislation. Health Minister Rona Ambrose has said Canada must improve its palliative care system before opening a debate on assisted death.

Undaunted, Fletcher plans to have his bills passed first in the Senate — a procedural gambit that would raise their status in the House of Commons.

Euthanasia and assisted suicide are now criminal offences punishable by up to 14 years in prison. Ending the prohibition on assisted death, Fletcher contends, “is the moral issue of our time.”

“Its importance will reveal itself in the peace of mind that it provides to individuals who are suffering — and their families,” he says. “It speaks to what it means to be human.”

Fletcher is grateful that he has a purpose-driven life, that he has been gifted with the opportunity to serve his country and his constituents. He’s thankful for the supports that allow him to live independently.

But he rejects the notion that his personal success stands as an argument against giving young people the ability to choose death in the darkest hour of their lives.

His bill would provide anyone over 18 the right to an assisted death if they face “intolerable” suffering.

Fletcher says it’s impossible to know what he would have done had such an option been available to him in January 1996, but he believes it would have been a comfort to know it existed.

Every day since the accident has been difficult. Fletcher can’t feel his body below his neck and sometimes wonders if it’s there at all. His body doesn’t know warmth or cold and takes on the temperature of his environment. He can’t control his bladder or bowel. There is little privacy and daily indignity. His head and neck are always in some measure of pain. And what he can’t feel can kill him: pressure sores, bowel blockages, lung infections.

At night, he sometimes dreams of running, canoeing or diving into a lake. And he’s constantly saddened at not being a husband and father — roles that, to him, have always defined personal success.

“The best, most important title I could have is dad, husband. I haven’t been successful on that front at all — and that has always been my number one goal in life.”

All of which is to say that Steven Fletcher wants the right to choose for himself the conditions under which he continues on this Earth. He doesn’t want to be forced to suffer in a more diminished state because of someone else’s ideas about the value of his life.

That conviction has made Fletcher a polarizing figure in the disabled community despite being its foremost political pioneer. Some disabled activists contend the MP’s right-to-die legislation would devalue their lives and increase their vulnerability during a medical crisis.

Fletcher disagrees.

“I’m disabled. I’m as disabled as you can get. But I don’t think my life is going to be in any way diminished because, in the hospital down the street, there’s less suffering.”

The Fletcher File

Born

June 17, 1972

Education

Master of Laws, University of London (2013-)

Masters of Business Administration, University of Manitoba (1998-2001)

This Week's Flyers

Comments

We encourage all readers to share their views on our articles and blog posts. We are committed to maintaining a lively but civil forum for discussion, so we ask you to avoid personal attacks, and please keep your comments relevant and respectful. If you encounter a comment that is abusive, click the "X" in the upper right corner of the comment box to report spam or abuse. We are using Facebook commenting. Visit our FAQ page for more information.